Skin cancer and drum corps

[Geoff]

Dr.,

Please feel free to post your original topic in both our main DCI forums and our main DCA forums, where you will probably get a larger response.

[LanceG]

Dr.,

Please feel free to post your original topic in both our main DCI forums and our main DCA forums, where you will probably get a larger response.

Will do. I'm going to do a promo for sun protection for the junior corps and then a skin cancer awareness campaign for the alumni group. I'll talk about sun screens in general, kids at risk for phototoxicity, and signs/symptoms of skin cancer. Should be interesting.

Lance Gee MD

Board Certified Family Practice

Kaiser Deer Valley Dermatology

[byline]

I'm being treated for more symptoms of actinic keratosis (the precancerous stuff) and being sent off to a dermatologist for further assessment. So it looks like this is going to be the way things are from here on out. Oh, well. Just did a story on skin cancer for our local paper's upcoming "Health Focus" magazine, so hopefully it opens a few eyes.

[steelcityrabbit]

This is right up my alley, although I claim no expertise, I am probally a great example.

backround:, 46 years old, irish red head with red hair and freckles, and had my 1st basil cell carcanoma (sp?) removed a few months back. It was on my neck. Just like byline, I have had several spots frozen and seem to be doing alright.

I have spent a lot of time in the sun since childhood, and like others my age, early on with no protection. I am also sad to say not very protective still. The weekend after I got diagnosed, I got a pretty good burn on my face and neck.

My father, who never marched, has been having things removed for at least 10 years now. He did work on a farm as a kid and said he was always burnt.

Funny story, 1985, my sisiter, who has the same skin make-up, went to a tanning salon. This was when they 1st started to appear. She went for 1 hour a day for 1 week and got a pretty nice tan, only $100!

I figured I( would too. A week later and a $100 poorer, I was red as a lobster. manager of tanning salon says with some, it takes a bit longer for the skin to take to the tan, OK, so now 2 weeks later and $200 poorer, I am even "redder".

The weird thing was that for that whole summer, I would go out in the sun all day with no protection, burn to a crisp, but it never hurt. Trust me, I have had some real good "sunburns" over the years.

OK, 2nd funny story. The doctor who did the surgery and I graduated from high school together. I asked about scarring and he said I could have plastic surgery to remove the scar. I said I wanted the scar and to make it look like a bullet wound. Good for telling stories when I get old and hang out at the VFW or American Legion.

[steelcityrabbit]

Let me add, you can't find pics of me before the age of 40 with shorts on, I never wore them. The only places I have problems with are my arms, neck and face.

[thedrumking]

I am 41 and have marched since '78. I jusy had a basil cell carcinoma removed as well. The funny thing is, it was in a place that was always covered, my chest. As a drummer I always had a harness on (or sling). Furthermore, I do not have the body design that would warrent taking off my shirt! I have had plenty of sun on arms, head and neck so I have to go every 6mos now I guess. Still on limited mobility for another 2 weeks.

[byline]

Just went to my doctor again this week to have more actinic keratoses frozen off, and will be going back again in another couple of weeks. I'll be my own Christmas tree for the holidays, LOL!

Because I have so many of these precancerous spots (mostly in the T-zone: face, shoulders, arms and upper chest, though I have found one on my left leg), it's likely that I will be using one of the creams available to treat them. The reason for this is because the cream can cover an entire surface area, as opposed to this sort of hit-or-miss approach with the cryotherapy. The one that's vastly preferable is a newer product called Aldara. The other one is 5-Fluorouracil topical (brand name Efudex), which is a topical chemotherapy treatment and, as such, has more serious side-effects. The main drawback to Aldara is the fact that it's pricer than Efudex, but I'm thinking it should be covered by our drug plan. Here's more info, in case anyone wants to check this out: Actinic Keratosis - Treatment

FWIW, I would suggest moving this thread into the main forum. This is info that is pertinent to everyone marching now, not just us old-timers.

Edited December 4, 2008 by byline

[byline]

FWIW, here's the "Health Focus" article I wrote. We got permission to usual a particular graphic showing the ABCDs of melanoma, but here's another link that gives clear comparisons (with photos) of normal moles vs. melanomas: About.com melanoma link

Skin cancer: Look for changes in skin appearance, texture

By SUE DESCHENE

Freelance Writer

When it comes to skin cancer, remember one word: change.

“You're basically looking for any changes in the skin,” explains Bonnie Schnittker, public health nurse with the Leeds, Grenville and Lanark District Health Unit. Such changes include:

* smooth, shiny bump or crater

* solid-red raised bump

* sore that doesn't heal

* sore or bump that bleeds and develops a crust or scab

* pink, red or brown patches that often go rough and scaly, then become itchy or tender

* yellow-white or stretched change in the skin

“It could start at the site of a burn, injury or scar, but then all of the sudden it starts changing after it's healed,” Schnittker adds. “Basically it's anything that's new or different, or wasn't there before.”

People who have freckles, moles or age spots need to be on the lookout for the ABCDs of skin cancer: asymmetry, border irregularity, colour and diameter (see graphic).

In addition to doing regular skin checks on their own, people should enlist their spouses or partners, hairdressers and massage therapists to look for changes on those parts of the body they can't see easily, such as the scalp and back, as well as the back of the neck, shoulders and legs. These “lookouts” are not in a position to diagnose, but they can alert people to changes in skin appearance and texture.

Often you can feel evidence of precancerous sun damage – called actinic or solar keratosis – even before you can see it. Tiny rough, raised patches may turn pink or red, accompanied by itching and peeling. Or you might feel some sensitivity when applying pressure to that area.

Any changes in skin appearance and texture – whether that be a new growth or change to an existing freckle, mole or age spot – raise a red flag, especially if they do not heal. Such changes warrant a visit with your doctor. They may signal something other than cancer, but they still need to be followed up.

The Canadian Dermatology Association describes the three types of skin cancer:

* Basal cell – most common, less dangerous although the cancer continues to grow, causing disfigurement; most commonly found on face and neck; can look red, scabby, like a sore that doesn’t heal.

* Squamous cell – second most common form, must be removed because lesions continue to grow and damage the surrounding tissue; they may grow quickly and look like a wart, scaly, open sore, crusted skin; appears on sun-exposed areas: neck, arm, back of hand and leg.

* Melanoma – less common, very dangerous if left untreated; it invades other skin, reaches the bloodstream or lymph system and spreads to other parts of the body.

Skin cancer often takes a long time to develop, Schnittker notes, which is why it's highly treatable if caught early. The problem is that some people wait too long, and the consequences may be dire.

The Canadian Cancer Society estimates the number of non-melanoma skin cancers in 2008 at 73,000 cases, with 260 deaths resulting from non-melanomas. For melanoma, the estimate is 4,600 cases … and 910 deaths.

Skin cancer is easily preventable. People who protect themselves from overexposure to ultraviolet (UV) radiation see their chances of developing skin cancer dramatically reduced. But because North Americans prize glowing, bronzed tans – with sunburn and other types of sun damage being an inevitable result – skin cancer is the price we pay.

“Skin damage (from UV radiation) is cumulative,” Schnittker says. “For each sunburn before the age of 18, that doubles your risk of developing skin cancers.”

The earlier in life one starts, the greater the risk. Even one severe, blistering sunburn as a child or teenager greatly increases the risk of developing skin cancer as an adult. That's why it is so important to protect children from sun overexposure.

It's also why teens need to understand that getting a tan or sunburn – whether that be outdoors or using artificial UV sources like tanning booths or sun lamps – is not a wise choice.

People with the greatest risk of developing skin cancer are fair-skinned individuals, those who sunburn easily or have moles, and those with a history of sunburn.

Areas of the body that receive the most exposure to UV rays are where skin cancers most often develop: face (especially the nose), neck, shoulders, arms, hands and legs. Areas which are often overlooked, but are susceptible to UV damage, include the top of the head, top of the ears, back of the neck and back of the legs.

The easiest way to protect yourself from skin cancer is to avoid overexposure to UV radiation. Prevent overexposure by avoiding peak UV periods. In eastern Ontario, this runs from late April or early May to late October, from about 11 a.m. to 4 p.m. daily.

If you must go out during those periods, apply a chemical sunscreen or sunblock (don’t forget your lips and ears), and also wear physical barriers to the sun such as a wide-brimmed hat, sunglasses and clothing to cover the body. And seek shaded areas whenever possible.

Sunburn isn't the only type of skin damage to worry about. Different types of UV radiation include UVA and UVB. UVA rays don't cause sunburn; they prematurely age and wrinkle the skin. They are also dangerous because they are more likely to damage the melanocytes, potentially leading to melanoma. UVB rays are the burning rays which can damage skin cell DNA. So check that your sunscreen product protects against both UV types.

This past summer, Environment Canada predicted that UV radiation levels were about four per cent higher than pre-1980 levels, due to the thinning of the ozone layer. Environment Canada and the Weather Network issue UV forecasts as part of their daily weather forecasts. These UV forecasts show peak UV periods, as well as the UV reading for that day, so that people can plan accordingly.

A reading of three or above means that people should take steps to protect their skin. The higher the reading, the greater the precautions needed.

Finally, keep in mind that there is no such thing as a “safe” tan. Tanning is nothing more than sun damage caused by your skin's attempt to protect itself from further damage by adding colour. Melanin – increased skin pigment – produces this darkening of the skin. But it is still sun damage, and that damage is cumulative.

And that old chestnut about getting a tan to protect yourself from sunburn doesn’t really work, as the sun protection factor (SPF) produced by the extra melanin in tanned skin is only about two to four, well below the minimum recommended SPF of 15.

People often wonder why a tan, something that looks so healthy, can do so much damage. “We refer to it as ultraviolet radiation, which is exactly what it is,” Schnittker says. “And when you say it that way – 'What do you mean, radiation?' – then maybe the terminology will help people to see it for what it is.”

For more information on skin cancer prevention and detection, visit these websites:

Ontario Sun Safety Working Group

http://uvnetwork.ca/

Canadian Cancer Society “Use SunSense” page

http://www.cancer.ca/Ontario/Prevention/Us...aspx?sc_lang=en

Canadian Cancer Society “What is melanoma?” page

http://www.cancer.ca/Ontario/About%20cance...aspx?sc_lang=en

MayoClinic.com melanoma video

http://www.mayoclinic.com/health/melanoma/MM00657

If you have further questions, contact your doctor or the Canadian Cancer Society:

1-888-939-3333

info@cis.cancer.ca

Edited December 4, 2008 by byline

[Dale Lofgren]

Good info above Sue.

I have gotten pretty good at identifying pre-cancers and basal cells. My first and only (so far) squamous was a complete surprise though. I was in for the usual 3 xs a year check and was almost finished with the appointment. Then, just for the heck of it, I asked the Dr. to check what I was sure was just a mosquito bite.

He looked and asked the dreaded question, "How long has that been there?"

I replied, "Two-to-three weeks."

It turned out to be a squamous that was surgically excised a couple of days later.

Watch for those mosquito /spider looking bites that do not heal in a week or two that may actually get a bit bigger.

[byline]

Good points, Dale. Also, my doctor noted that for these precancerous growths, you can often feel them long before you can see them. And that's certainly been true for me. They're these tiny rough/scaly patches on my skin that don't go away. I thought it was just dry skin as a result of aging. Nope! Those are the ones we've been freezing off every couple of weeks. Also, I had one on my forehead, just above my left eyebrow, that looked pinkish, almost like a pimple, but it wouldn't heal and kept peeling. That was the first one I had frozen off.

Something else to keep in mind is that not all unusual skin growths are precancerous or cancerous. For example, I have hemangiomas, which can look kind of scary, but they're basically nothing more than blood vessels extending up through the surface of the skin. My doctor was able to tell right away that that's what they are. One clue, she said, is that if you press on them, they blanch. Here's a page describing them: Growths and Malformations of the Vessels

Basically, her rule of thumb is that if you notice anything unusual, check it out with your doctor. It might be perfectly harmless, but it's better to know for sure.

Edited December 8, 2008 by byline